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Conservative surgical treatment of the mixed tumor of the palate
Section
of the
Federal dental services
Conservative surgical treatment of the mixed tumor of the palate
T
he
controversy
surrounding
tlic
liistogenesis
of
tlic
so-callcd
iniscd
tumor
began in the mid-nineteenth century, when Virchow’ pwscntctl his dctail4 wot~l~ describing the lesion’s complex histologic nioqd~olo~~, illld it persists to this very diay. Cheyne, Tiecke, and Home,” in an rswllcnt w\-ic\\-, discuss in detail the five t’awred theories regarding the histogmcsis oi’ thcb mind tlunor. ~~ltlcr~ Kline, and Fader,P in a statistical survey, also discuss a few of these histogcnetic theories. Jt is thought that no practical purpose would lw s~vcd by listing them here. As if this histogenetic controversy w-c~renot lwrylcsing enough: WC have bewrne conf’rontcd also with a choice of riorirc~ric1atur.c jvith rwpwt lo this tumor. Xomc investigators prefer the ncwcr term ~Acowor~$~ic~cldfJnf/wr t 0 the less descriptive, but more common tcrrii, ~ri.r,~d t II)I~~I’. Shafer, l-1inc, and IJcvyl share the general opinion that this tumor is not iwlly a “nrisctl” turnor in the true sense of being teratomatous 0~ deriving i’rofn nioi*c than ori0 pritnai*~t,issue. IJon.cvcr, througliout~ t,lic rcniainder of this article thv lwion will lw r~cfeiwd to as nzi.xt cl tumor- simply because that is tliv mow wriritwn riirmc, irlbcit a misnonicr. To complicate the picture still frrrtlicr, \v(x tlaYc wnflictiiig opinions as t,o which is the best method of twa tin g this ncol~lastir \vli(w it arisw in the ~Iillatt?. Clinicians univerxallagrw that Yadiation is. at lwst, of dubious value in these cases, and they arc fmtlrcr agrwtl that, srrrgical r~woral is 111~ this is ~vliwc: thv agrwincwt wgartlitig twatment of choice. lL~nfortunatcly, t,hcrapy ceases; some workers favor conservati~c surgic;ll intwvcntion irr xlrivh t,he tumor proper is enucloated without WIllO\-ill of sni~romitlinp palatal boric or soft tissue, nhilc others advocate a more radical a~~~m~vh. .L prcfvr the WIIscrrative surgical approaczh that will bc dcscribcd 1;1I(lr~in tlris discussion. The mixed tumor contains se\-era1 distirwt histologic clctncnts ; l~cwcc, its name, The chief element is the epithelial cell, wlric>h may assume arrJ7 slra[~~ 263
O.K. ()..\I. & ().I’. .tllpllst, 196;
Fi.q. 6
Fi(j.
8
of the
Federal dental services
Conservative surgical treatment of the mixed tumor of the palate
T
he
controversy
surrounding
tlic
liistogenesis
of
tlic
so-callcd
iniscd
tumor
began in the mid-nineteenth century, when Virchow’ pwscntctl his dctail4 wot~l~ describing the lesion’s complex histologic nioqd~olo~~, illld it persists to this very diay. Cheyne, Tiecke, and Home,” in an rswllcnt w\-ic\\-, discuss in detail the five t’awred theories regarding the histogmcsis oi’ thcb mind tlunor. ~~ltlcr~ Kline, and Fader,P in a statistical survey, also discuss a few of these histogcnetic theories. Jt is thought that no practical purpose would lw s~vcd by listing them here. As if this histogenetic controversy w-c~renot lwrylcsing enough: WC have bewrne conf’rontcd also with a choice of riorirc~ric1atur.c jvith rwpwt lo this tumor. Xomc investigators prefer the ncwcr term ~Acowor~$~ic~cldfJnf/wr t 0 the less descriptive, but more common tcrrii, ~ri.r,~d t II)I~~I’. Shafer, l-1inc, and IJcvyl share the general opinion that this tumor is not iwlly a “nrisctl” turnor in the true sense of being teratomatous 0~ deriving i’rofn nioi*c than ori0 pritnai*~t,issue. IJon.cvcr, througliout~ t,lic rcniainder of this article thv lwion will lw r~cfeiwd to as nzi.xt cl tumor- simply because that is tliv mow wriritwn riirmc, irlbcit a misnonicr. To complicate the picture still frrrtlicr, \v(x tlaYc wnflictiiig opinions as t,o which is the best method of twa tin g this ncol~lastir \vli(w it arisw in the ~Iillatt?. Clinicians univerxallagrw that Yadiation is. at lwst, of dubious value in these cases, and they arc fmtlrcr agrwtl that, srrrgical r~woral is 111~ this is ~vliwc: thv agrwincwt wgartlitig twatment of choice. lL~nfortunatcly, t,hcrapy ceases; some workers favor conservati~c surgic;ll intwvcntion irr xlrivh t,he tumor proper is enucloated without WIllO\-ill of sni~romitlinp palatal boric or soft tissue, nhilc others advocate a more radical a~~~m~vh. .L prcfvr the WIIscrrative surgical approaczh that will bc dcscribcd 1;1I(lr~in tlris discussion. The mixed tumor contains se\-era1 distirwt histologic clctncnts ; l~cwcc, its name, The chief element is the epithelial cell, wlric>h may assume arrJ7 slra[~~ 263
O.K. ()..\I. & ().I’. .tllpllst, 196;
Fi.q. 6
Fi(j.
8